Effect of 7 days of exercise on exogenous carbohydrate oxidation and insulin resistance in children with obesity

Appl Physiol Nutr Metab. 2018 Jul;43(7):677-683. doi: 10.1139/apnm-2017-0358. Epub 2018 Feb 2.

Abstract

The capacity to match carbohydrate (CHO) oxidation with CHO availability (deemed metabolic flexibility (MetFlex)) may be important for type 2 diabetes prevention. In adults, impaired MetFlex is associated with insulin resistance (IR), which can be improved with as little as 7 days of exercise. Whether this occurs similarly in children is unknown. We hypothesized that 7 consecutive days of exercise would improve MetFlex and IR in children with obesity. Twelve children (8 boys, 4 girls) completed 2 study visits before (PRE) and 2 study visits after (POST) exercise training. At visit 1, fasting blood was collected, and anthropometry and maximal oxygen uptake were assessed. At visit 2, a 13C-enriched CHO drink was ingested before exercise (3 × 20 min) at ∼59% maximal oxygen uptake. Exogenous CHO oxidative efficiency, used as a surrogate measurement of MetFlex, was calculated from breath samples. During training, participants alternated between continuous and high-intensity interval cycling sessions at home under supervision. In spite of good training adherence, there was no improvement in MetFlex (PRE: 20.7% ± 1.8%, POST: 18.9% ± 4.9%, p = 0.22) or homeostasis model assessment of insulin resistance (PRE: 8.7 ± 4.6, POST: 8.1 ± 6.0, p = 0.51). Future research should investigate exercise volume, sex, and pubertal effects on the early responsiveness of MetFlex to exercise therapy.

Keywords: children; enfants; entraînement physique; exercise training; flexibilité métabolique; insulin resistance; insulinorésistance; metabolic flexibility; obesity; obésité.

MeSH terms

  • Adolescent
  • Blood Glucose / metabolism
  • Body Composition
  • Body Weight
  • Child
  • Dietary Carbohydrates / metabolism*
  • Exercise*
  • Female
  • Glucose Tolerance Test
  • Humans
  • Insulin / blood
  • Insulin Resistance*
  • Male
  • Patient Compliance
  • Pediatric Obesity / blood
  • Pediatric Obesity / therapy*
  • Pilot Projects
  • Sample Size

Substances

  • Blood Glucose
  • Dietary Carbohydrates
  • Insulin